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Obsessive-Compulsive Disorder (OCD) in Children

What is obsessive-compulsive disorder in children?

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. A child with OCD has obsessive thoughts that are not wanted. They are linked to fears, such as touching dirty objects. He or she uses compulsive rituals to control the fears, such as excessive handwashing.

As children grow, rituals and obsessive thoughts normally happen with a purpose and focus based on age. Preschool children often have rituals and routines around meals, bathing, and bedtime. These help stabilize their expectations and view of their world. School-aged children often develop group rituals as they learn to play games, take part in team sports, and recite rhymes. Older children and teens start to collect objects and develop hobbies. These rituals help children to socialize and learn to deal with anxiety.

When a child has OCD, obsessive thoughts and compulsive rituals can become very frequent and strong. They may interfere with daily living and normal development. OCD is more common in teens.

What causes obsessive-compulsive disorder in a child?

The cause of OCD is not known. Research suggests it’s a brain problem. People with OCD don’t have enough of a chemical called serotonin in their brain.

OCD tends to run in families. So it may be genetic. But it may also develop without a family history of OCD. In some cases, streptococcal infections may trigger OCD or make it worse.

What are the symptoms of obsessive-compulsive disorder in a child?

Each child may have different symptoms. These are the most common symptoms:

Compulsive behaviors are the repetitive rituals used to ease anxiety caused by the obsessions. They can become excessive, disruptive, and time-consuming. They may interfere with daily activities and relationships. They may include:

Repeated handwashing (often 100 or more times a day)

Checking and rechecking many times, such as making sure that a door is locked

Following firm rules of order, such as putting on clothes in the very same order each day

Hoarding objects

Counting and recounting a lot

Grouping objects or putting things in a certain order

Repeating words spoken by oneself or others

Asking the same questions again and again

Repeatedly using four-letter words or making rude (obscene) gestures

Repeating sounds, words, numbers, or music to oneself

The symptoms of OCD may look like other health problems. Make sure your child sees his or her healthcare provider for a diagnosis.

How is obsessive-compulsive disorder diagnosed in a child?

A child psychiatrist or other mental health expert can diagnose OCD. He or she will do a mental health evaluation of your child. To be diagnosed with OCD, your child must have obsessions and compulsions that are continuous, severe, and disruptive. They must harm your child’s day-to-day living.

In most cases, the activities of OCD such as handwashing or checking the locks on doors use up more than 1 hour each day. They also cause mental health distress and affect how your child thinks. In most cases, adults realize that their actions are not normal to some degree. But often children are not able to see that their behavior is irrational and abnormal.

How is obsessive-compulsive disorder treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment for OCD often involves a combination of the following:

Therapy with cognitive and behavioral techniques. Cognitive techniques help a child identify and understand his or her fears. They also teach a child new ways to better resolve or reduce those fears. Behavioral techniques help the child and their family make pacts or rules to limit or change behaviors. One example is setting a maximum number of times a compulsive handwasher may wash his or her hands.

Family therapy. Parents play a vital role in any treatment process. A child’s school may also be involved in care.

Selective serotonin reuptake inhibitors (SSRIs). These medicines help raise levels of serotonin in the brain.

Antibiotics. Your child may need these medicines if his or her OCD is found to be linked to a streptococcal infection.

Teens with OCD may also have one or more types of eating disorders. These will also need treatment.

How I help prevent obsessive-compulsive disorder in my child?

Experts don’t know at this time how to prevent OCD in children and teens. But if you notice signs of OCD in your child, you can help by seeking an evaluation as soon as possible. Early treatment can ease symptoms and enhance your child’s normal development. It can also improve his or her quality of life.

How can I help my child live with obsessive-compulsive disorder?

OCD can be treated, usually with a combination of one-on-one therapy and medicines. You play a key supportive role in your child’s treatment. Here are things you can do to help your child:

Keep all appointments with your child’s healthcare provider.

Talk with your child’s healthcare provider about other providers who will be involved in your child’s care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, and psychiatrists. Your child’s care team will depend on your child’s needs and how serious the OCD is.

Keep strong and open lines of communication with your child. Children with OCD can feel embarrassed about their disorder.

Tell others about your child’s disorder. Work with your child’s healthcare provider and schools to develop a treatment plan.

Reach out for support from local community services. Being in touch with other parents who have a child with OCD may be helpful.

Key points about obsessive-compulsive disorder in children

OCD is a type of anxiety disorder. A child with OCD has obsessive thoughts that are not wanted. They are linked to fears, such as touching dirty objects. The child uses compulsive rituals such as handwashing to control the fears.

The exact cause of OCD is unknown. Children with OCD don’t have enough of a chemical called serotonin in their brain.

Obsessive symptoms include repeated doubts and extreme preoccupation with dirt or germs.